Your Appointment
Before your appointment with us, please either download or complete on-line the required patient forms in order to reduce the wait time for your appointment. Also, our automated phone system will call you the day before your appointment to remind you of the date and time of your visit with us.
Download Patient Forms
To view the forms listed on this page, you will need Adobe Reader. You may download Adobe Reader for free at www.adobe.com. Please bring your completed forms with you to your appointment.
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We Welcome You Informational
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Patient Packet All Doctors
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Payment Agreement Form All Patients
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Medicare Beneficiary Form Medicare Patients
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HIPPA Agreement
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Release of Medical Records from our Office
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Release of Medical Records to our Office
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HIPAA form to authorize release release of information to school, work, etc.
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Discrimination Notice
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Current Medication List
At East Alabama ENT our patients' health and well being has always been our #1 priority.
In compliance with the Governor's mandate:
- Face coverings are required at all times while in the Office
- Maintain 6 feet of separation while waiting be checked in and/or waiting to be seen for your appointment.
We want you to know that East Alabama ENT values the health of our clients above all else. We are taking appropriate measures to disinfect our office and to clean surfaces thoroughly after each appointment.
If you are feeling ill in any way, have travelled out of the country in the past month, or have been exposed to someone who has been ill, please call the office at (334) 705-0012 to reschedule your appointment.
If you need assistance but do not want to come to the office at this time, please call or click here to contact us and we will do our best to take care of you.
Thank you for your understanding and BE SAFE!
Have any issues with your Ears/Nose/Throat?
We partner with each patient to create the best Healthcare experience through the integration of the patient’s physical, emotional and intellectual health, one patient at a time.
